Schroth疗法治疗青少年特发性脊柱侧凸的meta分析  

Schroth therapy for adolescent idiopathic scoliosis:a meta-analysis

作　　者：陈阳[1] 王洁[2] 朱源棚 赵政晔 仉建国[2] 吴南[2] Chen Yang;Wang Jie;Zhu Yuanpeng;Zhao Zhengye;Zhang Jianguo;Wu Nan(Department of Orthopaedics,Beijing Puren Hospital,Beijing 100062,China;Department of Orthopaedics,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China)

机构地区：[1]北京市普仁医院骨科,北京100062 [2]中国医学科学院北京协和医学院北京协和医院骨科,北京100730

出　　处：《中华骨科杂志》2025年第7期429-435,共7页Chinese Journal of Orthopaedics

基　　金：中央高水平医院临床科研专项(2022-PUMCH-D-004,2022-PUMCH-C-033);国家临床重点专科建设项目。

摘　　要：目的分析Schroth疗法治疗青少年特发性脊柱侧凸的临床疗效。方法检索中国知网、万方数据知识服务平台、中国生物医学文献数据库、中华医学期刊全文数据库、PubMed、Embase、Cochrane Library、Web of Science中Schroth疗法治疗青少年特发性脊柱侧凸的临床研究。检索时间从建库至2024年11月。由两位作者分别独立进行文献检索,并将文献导入EndNote X9软件中,各自决定潜在纳入的文献是否符合纳入标准,如有分歧时则双方讨论解决或增加第三位作者进行评判。提取治疗后侧凸Cobb角和脊柱侧凸研究学会-22简明量表调查问卷(Scoliosis Research Society questionnaires-22,SRS-22)或SRS-23,比较Schroth疗法和其他保守治疗方法(功能锻炼或不干预)的组间差异。采用改良Jadad评分量表对纳入的随机对照试验进行文献质量评价。组间异质性较小时采用固定效应模型进行分析,组间异质性较大时采用随机效应模型进行分析。采用敏感性分析评估meta分析结果的稳定性。结果共8篇文献的189例患者纳入meta分析,其中中文文献2篇、英文文献6篇,均为随机对照试验,改良Jadad评分4~6分。Meta分析结果显示Schroth疗法治疗青少年特发性脊柱侧凸的侧凸Cobb角小于功能锻炼或不干预等治疗方法[WMD=-3.63,95%CI(-4.76,-2.51),P<0.001],SRS-22或SRS-23优于功能锻炼或不干预等治疗方法[WMD=0.23,95%CI(0.14,0.32),P<0.001],差异有统计学意义。亚组分析结果显示Schroth疗法治疗后侧凸Cobb角小于功能锻炼等其他保守治疗方法[WMD=-3.48,95%CI(-4.76,-2.20),P<0.001]。结论与其他保守治疗方法和不干预相比,Schroth疗法治疗青少年特发性脊柱侧凸能有效改善侧凸Cobb角和生活质量。Objective To analyze the clinical efficacy of the Schroth therapy in the treatment of adolescent idiopathic scoliosis.Methods Relevant clinical studies on Schroth therapy for adolescent idiopathic scoliosis were retrieved from CNKI,Wanfang Data,SinoMed,Chinese Medical Journal Full-text Database,PubMed,Embase,Cochrane Library,and Web of Science.The search time was from the establishment of the database to November 2024.Two authors independently conducted the literature search and imported all potentially eligible studies into EndNote X9 to determine whether the studies met the inclusion criteria.If there was any disagreement,the two parties would discuss and solve it or add a third author for judgment.The scoliosis Cobb angle and the Scoliosis Research Society question-naires-22(SRS-22)or SRS-23 were extracted from the scoliosis after treatment.The Schroth therapy was compared with other conservative treatment methods(functional exercise or no intervention).The modified Jadad scale was used to evaluate the quality of the included randomized controlled trials.When the heterogeneity between groups was small,the fixed-effect model was used for analysis,and when the heterogeneity between groups was large,the random-effect model was used for analysis.Sensitivity analysis was used to evaluate the stability of the meta-analysis results.Results A total of 189 patients from 8 literatures were included in the meta-analysis,including 2 Chinese literatures and 6 English literatures,all of which were randomized controlled trials,with a modified Jadad score of 4-6 points.The results of meta-analysis showed that the Cobb angle of Schroth therapy in the treatment of adolescent idiopathic scoliosis was smaller than that of functional exercise or no intervention[WMD=-3.63,95%CI(-4.76,-2.51),P<0.001].SRS-22 or SRS-23 was superior to functional exercise or no intervention[WMD=0.23,95%CI(0.14,0.32),P<0.001],and the difference was statistically significant.The results of subgroup analysis showed that the Cobb angle of Schroth treatment

关 键 词：青少年 脊柱侧凸 保守治疗 运动疗法 META分析 

分 类 号：R68[医药卫生—骨科学]